Open access scheduling discussed at Slate

Doctors can reduce their waiting times for appointments to essentially zero if they use open access scheduling, according to Marina Krakovsky at Slate.

The challenge of reducing waiting times is a classic queuing problem in operations research. Professionals in all sorts of service industries, from restaurants and hotels to banks and department stores, have faced it in one form or another. Most of them handle the juggling of clients far better than physicians, despite the lower stakes. Mounting evidence shows that doctors can see patients quickly, too—even in perennially backlogged practices—and that when they do, they benefit themselves and the people they treat…

When a patient calls in the morning asking to see a doctor who uses open access, the office offers an appointment for that same day. Why are there openings available? Well, the main reason most doctors defer today’s work to some time in the future is that today’s schedule is clogged with appointments made weeks ago. Doctors following the same-day scheduling model, on the other hand, are free today because they saw yesterday’s patients yesterday…

What’s required to make it work?

  • Working overtime to chip away at the existing backlog (otherwise there’s no free time to offer up)
  • Varying number of hours worked per day to accommodate fluctuating demand
  • Having the right sized patient panel –something that’s somewhat hard to assess in advance, since the true demand is unknown (offices usually just know how far out they are scheduling)

Why does it work?

  • There’s a high no-show rate from appointments made weeks or months in advance

I’ve advocated open access scheduling in the past and am glad to see Slate do a more thorough job of it.

September 5, 2007

One thought on “Open access scheduling discussed at Slate”

  1. Kaiser can’t shift their scheduling problems off to ERs, so of course they’re more motivated to try different scheduling schemes.

    I’d speculate they gave this consideration because their after-hours clinics were out of control with patients who needed to be seen but couldn’t get in during the day.

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